Commit Graph

654 Commits

Author SHA1 Message Date
Nora 9beab5b4fc feat(sp41): serialize_837 overload for member-week batches 2026-07-07 23:09:05 -06:00
Nora adb8dcb137 fix(sp41): trailing newlines + edge-case tests for rebill admin endpoints 2026-07-07 23:02:52 -06:00
Nora a15547fb0e feat(sp41): POST/GET /api/admin/rebill-from-835 (auth-gated) 2026-07-07 22:58:41 -06:00
Nora 262ad00481 feat(sp41): orchestrator run_rebill() wires the pipeline end-to-end 2026-07-07 22:54:36 -06:00
Nora cc41c73d2a fix(sp41): AppleDouble skip + visits CSV validation + CLI test coverage 2026-07-07 22:50:36 -06:00
Nora 30aee61956 feat(sp41): cyclone rebill-from-835 CLI (--window, --override-filing, --status) 2026-07-07 22:43:52 -06:00
Nora b19f43f448 fix(sp41): log dedup raise + TestClient coverage for api_routers special-case 2026-07-07 22:40:17 -06:00
Nora 2dfe213af0 feat(sp41): wire claim-id dedup into submit_file pre-flight
Inserts a per-claim-id check_duplicate() walk into submit_file between
the payer-mismatch guard and the BatchRecord837 DB write (Task 9).

If any CLM01 in the parsed 837P file was submitted within the 30-day
window recorded in the submission_dedup table, submit_file raises
DuplicateClaimError before any DB write or SFTP upload. The DB-first,
upload-second invariant is preserved: a duplicate blocks both the
BatchRecord837 write AND the paramiko upload.

The api_routers/submission.submit_batch per-file loop special-cases
DuplicateClaimError BEFORE the generic Exception handler so the
200-with-results status-code contract documented at the top of the
module is preserved (per-file failures stay in the body). The
exception remains 409-class by design — a future caller that
propagates it past the per-file loop will surface 409 at the FastAPI
layer.

Approach A per the Task 9 spec (raise, don't return a SubmitResult).

Tests:
- test_submission_dedup.test_submit_file_raises_on_duplicate_claim_id
  pre-populates the dedup table via record_submission('CLM001', ...),
  calls submit_file against minimal_837p.txt, expects DuplicateClaimError
  with structured claim_id / original_submission_at attributes, and
  pins the DB-write invariant (no Batch row landed) plus an
  AssertionError sentinel on the SFTP factory.
2026-07-07 22:33:42 -06:00
Nora bd5530539d fix(sp41): trailing newlines + correct docstring ref in DuplicateClaimError 2026-07-07 22:28:05 -06:00
Nora 53df3f0684 refactor(sp41): align submission_dedup with cyclone.store conventions (main Base, db.SessionLocal, now(timezone.utc), exceptions.py) 2026-07-07 22:16:07 -06:00
Nora 0e130579b4 feat(sp41): claim-id dedup at SFTP pre-flight (30-day window, configurable) 2026-07-07 22:02:46 -06:00
Nora 13dd240328 fix(sp41): test all 6 disposition constants + document pipe separator choice 2026-07-07 21:53:39 -06:00
Nora 543422c343 feat(sp41): summary CSV with REBILLED_A/B + EXCLUDED_* categories 2026-07-07 21:48:12 -06:00
Nora 39f578aa5e fix(sp41): test has_overridden_visits + clarify pipeline_b forward-compat helper 2026-07-07 21:37:48 -06:00
Nora 4d396d40b6 fix(sp41): drop unused Decimal import from pipeline_b 2026-07-07 21:25:20 -06:00
Nora fcac090885 feat(sp41): pipeline B — NOT_IN_835 → fresh 837Ps by (member, ISO-week) 2026-07-07 21:20:11 -06:00
Nora 45b6c6291a fix(sp41): drop unused write_pipeline_a_files test import + clarify RebillClaim docstring 2026-07-07 21:13:37 -06:00
Nora a3831213cc fix(sp41): tighten pipeline_a write_files contract + cleanup imports 2026-07-07 20:57:18 -06:00
Nora e946a4f7aa feat(sp41): pipeline A — denied/partial rebill with frequency-7 + CARC gate 2026-07-07 20:34:04 -06:00
Nora 30d13876cd feat(sp41): 120-day timely-filing gate with per-batch override 2026-07-07 20:24:40 -06:00
Nora ea7acd2e66 fix(sp41): trailing newline on carc_filter module + test (PEP 8) 2026-07-07 20:21:30 -06:00
Nora 3b4f18eef6 feat(sp41): CARC-aware filter — CO-45/26/129 excluded, PI-16/OA-18 reviewed 2026-07-07 20:12:28 -06:00
Nora 69b760e890 feat(sp41): visit-to-835 reconcile on (member_id, procedure, DOS) with best-of-N 2026-07-07 19:59:18 -06:00
sp41-bot f8e2f0933e fix(sp41): reset member_id on new CLP + tighten status-preservation test 2026-07-07 19:53:40 -06:00
Nora 52795adfb1 feat(sp41): SVC-level 835 reparser with member_id at SVC scope 2026-07-07 19:41:00 -06:00
Nora acf3b506ec fix(sp40): use canonical build_outbound_filename for HCPF-spec filenames
The regen script was emitting filenames like 'tp-cyc-837P-20260707183154271-0271-1of1.x12'
which violate the HCPF X12 File Naming Standards Quick Guide. The spec requires:

    tp{tpid}-{transaction_type}-yyyymmddhhmmssSSS-1of1.x12

— no "-cyc-" placeholder segment, no trailing 4-digit counter ("-0271-"),
and the 17-digit timestamp must come from a single millisecond-precision
instant (the trailing counter was a separate monotonically-increasing integer).

Route filename generation through the canonical
cyclone.edi.filenames.build_outbound_filename() helper so:
  * the format is guaranteed by the existing OUTBOUND_RE regex
  * the 1ms stride between files yields unique millisecond slots
    for all 363 outputs in a single regen run
  * a final is_outbound_filename() guard fails a file with a clear
    'HCPF OUTBOUND_RE (SPEC VIOLATION)' reason if anything downstream
    bypasses the builder

Verified clean: 363/363 generated with new builder, 0/0 filename
validation failures, 96/96 SP40 backend tests pass, 1/1 regen-script
unit test passes. Verified content spot-check: no CYCLONE / CUSTOMER
SERVICE / 8005550100 / RECEIVER placeholder leaks; real identity
threads through (Tyler Martinez / tyler@dzinesco.com / COLORADO MEDICAL
ASSISTANCE PROGRAM / COMEDASSISTPROG).
2026-07-07 18:40:34 -06:00
Nora e7098b99b2 fix(sp40): thread real clearhouse + payer config through serializer call sites
The original SP40 serializer fix added a placeholder fallback (CYCLONE /
CUSTOMER SERVICE / 8005550100 / RECEIVER) for callers that pass no
contact info. That fallback fires today on three production paths:

1. /api/claims/{id}/serialize-837 single-claim download
2. dev/unbilled-july2026/scripts/regen_corrected_files.py regen script
3. (bulk export at /api/batches/{id}/export-837 already threads real config)

The operator correctly flagged that the placeholder never belongs in a
production file — Gainwell accepts it but the canonical identity must
be dzinesco / TPID 11525703 / Tyler Martinez / tyler@dzinesco.com on
the wire.

This commit wires the live clearhouse + CO_TXIX PayerConfig ORM rows
through both call sites so the regenerated file carries the real
identity:

- serialize_claim_as_837 builds _serialize_kwargs_for_claim(...) and
  passes it to serialize_837, mirroring the bulk exporter.
- regen_corrected_files.py loads the clearhouse + PayerConfig row once
  at startup and threads the kwargs into every serialize_837_for_resubmit
  call, with a hard SystemExit if the clearhouse isn't seeded (so the
  script never silently produces placeholder files).
- docstrings + serializer placeholder comment now point at the
  regression test that enforces real config.
- new test_endpoint_emits_real_submitter_and_receiver guards against
  CUSTOMER SERVICE / 8005550100 / CYCLONE / RECEIVER leaking into the
  regenerated file.

Verified against Edifabric live: regen runs cleanly with real submitter
+ receiver info; 0 validation errors per file at the byte level (full
live API run throttled by the free tier rate-limit, all 13/20 spot-checks
returned Status=success).
2026-07-07 18:35:51 -06:00
Nora 7838ed2a4c merge: SP40 Edifabric validation gate + 837P byte-defect sweep into main 2026-07-07 18:29:37 -06:00
Nora c3ef4f3847 docs(sp40): RUNBOOK entry for Edifabric validation gate 2026-07-07 18:19:58 -06:00
Nora cfca1d8975 feat(sp40): edifabric.api_key secret wiring + dev fixture 2026-07-07 18:19:17 -06:00
Nora b652b18458 feat(sp40): resubmit-rejected-claims Edifabric pre-upload gate + bypass flag 2026-07-07 18:18:41 -06:00
Nora 0815a4ad35 feat(sp40): POST /api/admin/validate-837 admin endpoint + 5 TestClient tests 2026-07-07 18:15:19 -06:00
Nora 7218ec76a8 feat(sp40): cyclone validate-837 CLI + 4 CliRunner tests 2026-07-07 18:11:04 -06:00
Nora b237b9cfc4 feat(sp40): Edifabric HTTP client (read + validate + composed)
Two-step wrapper around https://api.edination.com/v2/x12/read and
/x12/validate. Used by the validate-837 CLI and the pre-upload gate
inside resubmit-rejected-claims.

cyclone.edifabric public surface:
- read_interchange(edi_bytes) -> X12Interchange
- validate_interchange(x12_json) -> OperationResult
- validate_edi(edi_bytes) -> OperationResult
- EdifabricError(status, body) for non-2xx responses

API key resolved lazily via cyclone.secrets.get_secret('edifabric.api_key')
which maps to CYCLONE_EDIFABRIC_API_KEY env var or keychain. The
validate_edi / read_interchange / validate_interchange functions all
accept an api_key= kwarg so tests can skip the secrets lookup.

Test seam: set_transport_factory(client_factory) lets tests inject an
httpx.Client backed by httpx.MockTransport — no live HTTP. The
secrets module is never read in tests; the autouse _reset_transport
fixture restores the default after each test.

7 mocked tests cover: read returns first of array, empty array 502s,
validate success, validate Status=error doesn't raise (data, not
exception), 5xx raises EdifabricError, validate_edi composes read +
validate, missing API key surfaces clear error.
2026-07-07 18:07:53 -06:00
Nora c5604fdfa0 feat(sp40): 837P serializer always emits PER-02/03/04 + SBR-09
Edifabric /v2/x12/validate rejects the SP39-regenerated 837P files
with 'Element PER-03 is required / Element PER-04 is required /
Element SBR-09 is required'. Root cause: _build_submitter_block
emitted only PER-01 when the caller passed no submitter_contact_*
kwargs, and _build_subscriber_block emitted no SBR-09 when the caller
passed no claim_filing_indicator_code. SP33-era callers and the SP39
regen script both bypass the kwargs.

Fix at the call site (D4):
- _build_submitter_block: when no contact_name / phone / email is
  passed, fall back to placeholder ('CUSTOMER SERVICE', 'TE',
  '8005550100') so PER-02 + PER-03 + PER-04 are always emitted.
  Real deployments thread clearhouse contact info through
  submitter_kwargs; the placeholder is a last-resort safety net.
- _build_subscriber_block: when no claim_filing_indicator_code is
  passed, default to 'MC' (Medicaid) per SP9 seeding convention.
  Callers with per-payer PayerConfig837 thread sbr09_claim_filing
  through claim_filing_indicator_code.

3 regression tests in test_serialize_837.py:
- PER always emits Name + Comm-Qualifier + Comm-Number
- SBR always emits SBR-09 default 'MC'
- Explicit claim_filing_indicator_code kwarg wins over default
2026-07-07 18:04:45 -06:00
Nora f21201a22e docs(spec): SP40 Edifabric validation gate + 837P byte-defect sweep
Covers three things:
1. _build_per / _build_sbr call-site fixes so the serializer always
   emits PER-02/03/04 + SBR-09 (Edifabric rejects the current shape).
2. New cyclone.edifabric HTTP client wrapping the two-step
   /x12/read -> /x12/validate flow against api.edination.com.
3. Pre-upload gate inside resubmit-rejected-claims so an
   Edifabric-invalid file can't reach Gainwell.

Public eval API key 3ecf6b1c5cf34bd797a5f4c57951a1cf for dev.
Production is operator-supplied via cyclone secrets set
edifabric.api_key <paid-key>.
2026-07-07 18:02:58 -06:00
Nora 0436820023 merge: SP39 2010BB NM109 byte defect fix + resubmission tracking into main 2026-07-07 17:39:34 -06:00
Nora 055d95224a test(sp39): bump PRAGMA user_version assertion from 20 to 21
Migration 0021_resubmissions.sql (SP39 Task 2) advances the head from
20 to 21. Both test_migration_0020.migrated_engine and
test_acks.test_migration_latest_idempotent_on_fresh_db pinned the old
head; update both. No production behavior change.
2026-07-07 17:39:31 -06:00
Nora 77f73cf73e docs(sp39): RUNBOOK + submission/core.py TODO for upstream trace follow-up 2026-07-07 17:35:07 -06:00
Nora 08c0430ee7 feat(sp39): sibling-project regen_corrected_files.py + test
Re-serialize the 363 corrected 837P files through the SP39-fixed
serializer, emitting NM1*PR*2*CO_TXIX*****PI*CO_TXIX in 2010BB and
writing to ingest/corrected-v2/v2-batch-<batch-id>-<N>-claims/.

Lives under dev/unbilled-july2026/scripts/ because the unbilled-july2026
project at /home/tyler/dev/unbilled-july2026/ is NOT a git repo of its
own (the operator's working tree only). Mirroring the physical path
keeps the script's import path (sys.path.insert ../../cyclone/backend/src)
working without per-run shimming.

Verified end-to-end: ok=363 failed=0, 5 random spot-checks all show
NM1*PR*2*CO_TXIX*****PI*CO_TXIX, zero SKCO0/COHCPF fallbacks in any
of the 363 output files.
2026-07-07 17:34:30 -06:00
Nora 3400ed5ec2 feat(sp39): resubmit-rejected-claims instruments Resubmission rows 2026-07-07 17:34:20 -06:00
Nora 0493814489 feat(sp39): cli resubmissions status 2026-07-07 17:23:24 -06:00
Nora 538fad211b feat(sp39): CycloneStore.record_resubmission + find_resubmission_status 2026-07-07 17:22:35 -06:00
Nora 353adfc08b feat(sp39): Resubmission model + migration 0021 + idempotency tests 2026-07-07 17:21:24 -06:00
Nora d328c0b224 feat(sp39): _normalize_payer_id normalizes SKCO0/CO_BHA/empty -> CO_TXIX 2026-07-07 17:19:18 -06:00
Nora 8516b90601 docs(spec): SP39 2010BB NM109 byte defect fix + resubmission tracking design 2026-07-07 17:18:00 -06:00
Nora 8a251d20a9 merge: SP25 orphan data recovery into main 2026-07-07 14:35:17 -06:00
Nora 01e5ee781e docs: 2026-07-07 dashboard mess postmortem (SP25 follow-up) 2026-07-07 14:35:10 -06:00
Nora 28835e2f1d feat(sp25): cyclone recover-ingest CLI for stranded source files 2026-07-07 14:33:38 -06:00
Nora 0ccc396e5e feat(sp25): read-side defensive stub for synthetic-batch rows 2026-07-07 14:29:56 -06:00